IV. Health promotion and communication

These enablers will be reviewed and considered in implementation research for the rollout of the UHC.

Finally, as the country moves towards UHC, it is imperative that all activities that will influence the design of the financing for UHC, whether PhilHealth, DOH grants or LGU subsidies, should take into consideration the private sector. Under the integration of the health system into a province-wide and citywide HCPN, the private sector should be made an integral part and be included in the referral mechanisms (such as sputum transport and access to RDTs), in feedback mechanisms (such as in laboratory connectivity and the follow-up of notified patients), and in financing (e.g. contracting as part of health care provider network, PhilHealth reimbursements for notification/treatment and performance-based grants for conduct of ACF activities), among other aspects of the HCPN.

Key milestones

➢ Road map for private sector engagement developed and integrated in TB NCC Performance

Framework (2020) ➢ Incentives for private sector engagement established: access to Xpert via STRiders (2020), follow-up of notified patients for outcome (2021) ➢ Performance-based grants to private sector for conduct of ACF under the HCPN (2021) ➢ Private sector notification linked to PhilHealth reimbursements (2022) ➢ Compliance by private sector to standards of care manifest by at least 50% of notified cases bacteriologically confirmed and at least 80% that have treatment outcome (2023)

IV. Health promotion and communication

There is a PhilSTEP1 sub-plan, the National TB Health Promotion and Communication Strategy (http://ntp.doh.gov.ph/downloads/publications/Health_Promotion_and_Communication_Strategy. pdf) that outlines the various health promotion strategies aimed at both the influencers (i.e. decision- makers at all levels of government, health service providers, media practitioners, civil society and allies from other sectors) and the individuals affected by TB (i.e. patients, survivors, their families and contacts). Based on the perceived gaps in health behavior, as identified in the plan’s situational analysis, the Health Belief Model was used as framework to identify what messages and campaigns will achieve optimal behavior change by targeting perceived barriers, benefits, self-efficacy and threats.

The communication objectives are clearly enumerated according to desired knowledge, feelings and actions, both of influencers and individuals affected. These desired behaviors are all anchored on the cascade-of-care continuum. Hence, a decision-maker will have desired actions for screening (e.g. fund activities for screening), testing/diagnosis (e.g.,\ invest in recommended diagnostic tools), treatment (e.g. ensure adequate drug supply) and prevention (e.g. fund TPT initiatives). Similar behaviors are spelled out for the other participants or targets of the messages.

There are five strands of communication strategies that will be implemented, namely:

i. policy advocacy ii. media advocacy iii. interpersonal communication and counseling iv. community mobilization, and v. behavior change communication.

Different activities are planned for each of the five strands with messages and methods suited to the target audience. For behavior change communication, which aims to influence specific behavior of the direct beneficiaries of the program, activities include digital activation (social media campaigns); health education during ACF, IFC and EC; radio and television promotions; and out-of-home media promotion (e.g. billboards and signage).

Key milestones

➢ Launch of the NTP Health Promotion and Communication Strategy (2020) ➢ Implementation of Waves 1 to 4 of the Health Promotion and Communication Campaign (2020–2023)